[Fat Bear Science] Can you still have sex and have children if you have breast cancer?

Compared with older breast cancer patients, young patients have higher requirements for quality of life. In terms of surgical selection, young patients tend to choose breast conservation or breast reconstruction rather than radical surgery. The impact of surgical treatment on women is reflected in both psychological and physiological aspects. Psychologically, women worry about whether sex is harmful to their body and dare not have sexual thoughts. On the other hand, they feel lost and inferior because of their own body defects, and even think that they are no longer a "complete" woman, and worry whether their husbands still love them.

For breast cancer patients who have undergone surgery, they often have a fear of having sex. Can breast cancer patients have sex after surgery? Will sex lead to breast cancer recurrence? How should they have sex with their loved ones correctly? All kinds of doubts not only increase the psychological pressure on breast cancer patients, but also cast a shadow on the harmony of their married life.

Breast cancer patients rise to first place in the world

Breast cancer refers to a malignant tumor that occurs in the mammary gland epithelial tissue. The incidence rate is approximately 34/100,000 to 44/100,000 (depending on the region). 99% of cases occur in women and 1% in men.

Data from the World Health Organization's International Agency for Research on Cancer show that in 2020, more than 2.26 million women worldwide will suffer from breast cancer, accounting for approximately 11.7% of all new cancer cases and 24.5% of new cancer cases in women, ranking first among new cancer cases among women.

In terms of number, it has surpassed lung cancer (11.4%) for the first time, becoming the cancer with the most diagnoses in the world. Relevant data show that the peak age group for breast cancer in urban women in my country is 55-60 years old, and the peak age group for breast cancer in rural women is 45-50 years old and 55-60 years old. The peak age group for breast cancer has a tendency to gradually increase.

Delayed childbirth and lack of exercise are important causes

Why has breast cancer surpassed lung cancer to become the most common cancer worldwide? Further analysis of the relevant reasons revealed that significant changes in lifestyle, social and cultural background, and living environment have had a significant impact on the occurrence of breast cancer. These risk factors include:

Postponing childbearing. Childbearing is a protective factor for breast cancer. Data show that women who have never given birth have a 30% higher risk of developing breast cancer than women who have given birth. The relative risk of first-time mothers over 35 years old developing breast cancer is 3 to 4 times that of those under 30 years old.

Fewer births. A Norwegian study found that having multiple births can reduce the risk of breast cancer by 10% to 13% for each additional birth.

Weight gain. The obesity rate in countries with a high incidence of breast cancer is mostly over 15%. The higher the body mass index, the greater the risk of breast cancer, especially for postmenopausal women. The risk of cancer increases by nearly 30% for obese women.

Lack of exercise. The Japanese Breast Cancer Society published a meta-analysis pointing out that sedentary time is proportional to the risk of breast cancer. For every additional hour of sitting per day, the risk of breast cancer increases by 1%. my country is currently a developing country and is also facing rapid changes in lifestyle, social culture and living environment.

Early detection, early diagnosis and early treatment are the key

How to detect it early? Women can do self-examination. They can do it by "looking, touching and squeezing" every day. For example, when taking a bath, first observe whether the breast shape is a normal arc contour, whether the nipple is inverted, the breast skin changes, and whether the breast has a "dimple"-like depression; second, touch the breast for lumps; third, squeeze the breast or nipple to see if there is fluid overflowing from the nipple or bleeding. If any abnormality is found, go to the hospital immediately for a breast specialist examination. In addition, regular screening of breast color ultrasound and breast molybdenum palladium can also detect breast lesions in time.

In terms of treatment, although they are all breast cancer, doctors adopt different treatment plans due to different pathological types, different patient constitutions, or different early and late stages of the disease. The treatment of breast cancer mainly includes local treatment surgery (surgery, radiotherapy) and systemic treatment (chemotherapy, endocrine therapy, molecular targeted therapy, etc.). The 5-year survival rate of early breast cancer is high and the treatment effect is good, which can reach more than 95%. If it reaches the middle and late stages, the cost will rise and the survival rate will drop sharply to less than 40%.

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Answers

Q

Can breast cancer patients have sex after surgery?

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Indeed, after breast cancer surgery, sexual desire may decrease due to physical weakness, endocrine system, and medication. However, with postoperative recovery, sexual life can be fully restored.

The restoration of sexual life is an important part of the restoration of normal life. A normal, moderate and harmonious sexual life can not only deepen the relationship between the couple, but also make the patient happy physically and mentally, improve the body's immune function, and is beneficial to the recovery of breast cancer patients. It should be reminded that during treatment, pay attention to contraception. It is not recommended to take birth control pills, because the estrogen and progesterone in birth control pills have an adverse effect on the treatment of breast cancer. It is encouraged to use tools for contraception or insert intrauterine devices.

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Can sexual activity cause breast cancer to recur?

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Some breast cancer patients often worry that sex will affect their recovery after surgery and even increase estrogen in their bodies, leading to the recurrence of breast cancer. Some patients also worry that the tumor will be transmitted through sex. In fact, these concerns are unnecessary. First, tumors will not be transmitted to the other party through sex; second, current medical research data show that appropriate sex during cancer recovery is not only harmless to the body, but also can boost the spirit, restore the patient's confidence, and face life again. However, it should be noted that during treatment (surgery, radiotherapy), the frequency of sex should be appropriately reduced to avoid excessive physical exhaustion, and sex should be limited to not feeling tired the next day.

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How can breast cancer patients have a harmonious sex life after surgery?

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If the couple respects and loves each other after breast cancer is diagnosed, the sex life is pleasant and satisfying, and it will return to normal after the disease. The spouse should take the initiative to care for and understand the patient and help her overcome her inferiority complex. Both parties should be honest about their sexual needs and feelings. Silence is the biggest enemy of sexual health. If you never dare to ask for advice, you will never be free. The ability to get pleasure through caressing will not change. Partners should try other ways to feel sexual pleasure. They should help each other and try sensual massage, and use touch and caress to help reach orgasm. When resuming sex after surgery, if the surgical incision or wound has not healed completely, try to reduce the compression of the chest to avoid distraction due to pain and discomfort. Breast cancer treatment may cause vaginal dryness, pain during intercourse, etc. You can use vaginal lubricants or condoms with lubricants. Side effects during treatment may cause menopause, but they may not reach the level of menopause. There is still a possibility of conception, so you still need to pay attention to contraception. When "making love", don't forget to pay attention to her body tolerance.

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Is it still possible to have children after breast cancer surgery?

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Under normal circumstances, the body's endocrine system often changes during pregnancy, and the levels of hormones such as estrogen, adrenocortical hormones and prolactin will increase exponentially. These hormones are closely related to the incidence of breast cancer and often stimulate tumor growth faster. Therefore, breast cancer patients should not become pregnant or breastfeed during treatment. Breast cancer recurrence is common 2-3 years after surgery, so if you want to get pregnant after surgery, you should wait for a period of time and complete it under the guidance and follow-up of a professional doctor.

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Zeng Xiaohua

Director of the Breast Cancer Center of the Affiliated Cancer Hospital of Chongqing University, chief physician, doctor of medicine, postdoctoral fellow, and master's supervisor.

He is particularly good at breast cancer surgery, such as modified radical mastectomy, breast-conserving radical mastectomy, axillary surgery (sentinel lymph node biopsy), primary breast reconstruction after breast cancer surgery (latissimus dorsi, rectus abdominis, prosthesis reconstruction, etc.), and secondary breast reconstruction after breast cancer surgery. He has profound attainments in early diagnosis of breast cancer, personalized treatment of locally advanced breast cancer, multidisciplinary comprehensive treatment such as adjuvant chemotherapy, endocrine, biological targeted therapy after breast cancer surgery, and rescue treatment of advanced breast cancer.

Clinic Hours

Monday morning special outpatient clinic: 08:00-12:00

Monday afternoon expert consultation clinic (medical history registration required): 15:00-17:30

Wednesday morning specialist clinic: 08:00-12:00

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Zhao Jing

Breast Cancer Center, Affiliated Cancer Hospital of Chongqing University (full-time nurse, head nurse, lymphedema rehabilitation therapist, hospital-level star nurse.

She has been engaged in clinical nursing for 10 years. So far, she has provided detumescence treatment for more than 100 patients with breast cancer-related lymphedema. She has published 5 papers in nursing journals, obtained 1 international invention patent, 7 domestic utility model patents, 5 computer software copyrights, and 2 new nursing technologies.

Text/Fat Bear

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